The secret to raising smart kids

“Rather than thinking about how to make your child or teen ‘smart’, pivot your thinking. While success has numerous definitions, I like to define it as having a strong work ethic, a developed sense of determination and realistic goal achievement,” says Dr. Rothman, Clinical Psychologist for Child and Youth at Medcan.

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Achieve more with a stable core

How to brace your core for proper posture (and decrease back pain)

By Tania Haas

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If you want to stand taller and diminish back pain, your focus should be directed to your middle.

“Our core muscles are there to help protect our joints,” says Marlo Goldstein, BSc.Kin, MSc., a fitness trainer at Medcan with a background in functional movement and pain rehabilitation therapy. “It is critical to establish core endurance to help maintain the long periods of sitting and standing we find ourselves in these days. Using proper patterns of muscle firing is key to ensure we maintain stability in our body and help prevent pain.”

Stable stomach, stronger posture, less pain

Goldstein explains that muscles are weakest when they are in a shortened position and/or too elongated. Our sitting and driving culture, where our core muscles are in a weaker position, can be a contributing factor to back pain.

“By strengthening our core we are bringing the muscles back towards their neutral position – opening the hips, the chest and turning on the glutes, which make us more stable,” says Goldstein. “Our spine is most stable when it is in its neutral state and more vulnerable when closer to its extremes.”

Support a neutral spine through ‘brace and breathe’

In order to initiate core work, Goldstein uses specific exercises and assessments to establish an individual’s neutral position.

“I ask my clients to brace their core as if they are preparing for impact — as if someone was going to throw a punch to their gut. We all tighten our core muscles in that imagined scenario,” says Goldstein. “Then we practise breathing into this braced core. The goal is to conduct this type of core work while being functional. Bracing and breathing your core while typing, while walking, while driving. The more you practise ‘brace and breathe’ in your workouts, the more you’ll be able to replicate it in your daily activities. Pain may lessen and posture may improve.”

Getting there starts with foundational core exercises, of which there are many. Goldstein describes some techniques and exercises below.

Brace and breathe

  • Lie on your back with a neutral spine (ears over shoulders over hips)

  • Place your hands beside your hip bone

  • Brace your core and hold for 10 seconds. You will feel that space between your hip bone and abs get tight. Try to maintain your breath while holding your core tight. Let go, and repeat again 5 times

  • This should be about 20% effort of “bracing”

Brace, breathe and lift

  • With a neutral spine, brace your core, lift one leg and then lift the other into a 90 degree position

  • Your legs should be close to your body so your neutral spine is kept at all times

  • Hold this position while breathing for 30 seconds and then take one leg down slowly and then the other (Repeat 3 times)

Brace, breathe and drop/kick

  • With a neutral spine, brace your core

  • Lift one leg and then the other into a 90 degree position

  • Hold this position, breathing for 30 seconds and then kick one leg straight and then the other

  • Move from your hips and not your knee. Repeat 10 times per side (Repeat for drops)

Plank

  • From your elbow or hands, please lift your body into a neutral spine (toes are on the floor and glutes are raised into the air)

  • Pretend there is a dowel on your back and it hits the top of your head, upper back and glutes

  • Keeping your core braced, hold for one minute

  • Pretend like you are pushing the floor further into the ground, this way we activate those important muscles in your upper back which help stabilize the shoulder

How glute strength supports your knees

Core and glute strength are inextricably linked

By Tania Haas

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We’ve already shared how a strong, braced core protects joints and can prevent back pain. Let’s add our backsides to the conversation.

“In most cases, if our transverse abdominals are weak, our glutes are too. The body’s central foundation requires strong glutes,” explains Victoria Di Cicco, a fitness trainer at Medcan. “Anatomically speaking, glutes support your lower back. From a functional standpoint – how you operate outside of the gym environment – activated glutes are the best protection against wear and tear on the knee joints.”

Prevent wear and tear on knee and other joints

She explains that without strong glutes, there’s an increased dysfunction at the knees. For example, when lowering into a squat, people with weak glutes have a tendency to incorrectly load their knees, putting too much pressure  on those joints. When the glutes are strong, the pelvis tracks back in a squat,  evenly distributing weight across both hip and knee joints. This proper motion of the hips relieves pressure on the knees.

Those with weak glutes have a higher probability of developing problems such as IT band syndrome, runner’s knee, and also issues with feet.

Strong glutes prevent lower back pain

While strong core muscles keep the pelvis in alignment, Di Cicco explains how our glute muscles can be considered back-up support. The three major muscle groups – gluteus maximum, gluteus medius, and gluteus minimus — help stabilize the pelvis and the spine. They also encourage more rotation in the legs and keep the hips mobile.

“By protecting the lumbar spine, we ensure the back is supported in the ideal neutral spine position. Without this glute support, the pelvis can get stuck in anterior tilt, rather than posterior tilt, and that can lead to long-term discomfort and mobility challenges.”

Activate glutes outside of the gym

When walking: be conscious of squeezing the glute muscles while the leg goes into extension and be sure to “push” the ball of the foot as if you are springing into your next step – this will help strength the glute complex.
When seated: get up every two or three hours to allow the glute fibers to go back to a more shortened and contracted state.
When climbing stairs: plant your whole foot on the step and extend the leg and hip as if you were performing a single leg step up exercise, which will help strengthen hamstrings and glutes.

Glute exercises at the gym

When attempting standing exercises like squats or deadlifts, be sure to have a spot or support from a personal trainer to avoid injury. Di Cicco prefers to start with floor exercises to ensure a strong foundation.

Standing Glute Activation

  • Stand with feet hip width apart and be sure to have all joints stacked on top of each other [knees over feet, hips over knees, shoulders over hips]

  • Take a deep inhale and on your exhale squeeze your glutes as hard as you can

  • On your next inhale let the glutes relax

  • Repeat for 10-20 repetitions

Hip Raise

  • Lie back down on the floor with your feet a few inches away from your bottom

  • Take a deep inhale and on the exhale “tuck your pelvis under” and press your hips up to the ceiling while slowing coming down on the inhale

  • Be sure not to overextend the spine when lifting the hips up as this will strain your back – this is important to avoid lower back pain and to ensure your core is working

  • Repeat 10-20 repetitions

  • I would strongly recommend adding in an isometric hold to increase neuromuscular response and difficulty

Marching Hip Raise

  • Lie back down on the floor with your feet a few inches away from your bottom

  • Take a deep inhale and exhale to extend your hips up to the ceiling

  • While continuing to breathe, keep your hips up and alternate by lifting one leg at a time to bring your knee into your chest and back down

  • Complete for approximately 1 minute or as long as you can perform this exercise with proper form

Farmer's market finds for August

Move over oranges, new vitamin C options are in season

By Tania Haas

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Artichokes

Look for

  • Closed heads: the leaves should form tight, compact layers

  • Firm and feel heavy for its size

  • Brown stem neither slimy or dry

“Fresh artichokes will last up to a week, but like all veggies they are best used as soon as possible after harvest,” says Nadine Khoury, registered dietitian and Clinic Manager, Nutrition Services. “If cut more than a few hours ago the stem will be brown, but it shouldn’t feel slimy or dry. Keep artichokes loosely wrapped in plastic in the fridge.”

Health benefits

  • Super high in antioxidants: linked to reducing tissue and organ damage and aging

  • Fibre: prevents constipation, hemorrhoids, and diverticulosis

  • Folic acid: supports protein metabolism; red blood cell formation; cell division and growth

  • Vitamin C: for wound healing, collagen formation; maintaining healthy gums and blood vessels

  • Vitamin K: for proper blood clotting or coagulation

How to prepare
Khoury likes to trim artichokes like this, then salt/pepper and steam with slices of lemon on top of each artichoke in a pot with a drizzle of olive oil, one cup of water and the juice of half a lemon fhttp://localfoods.about.com/od/artichokes/tp/aboutartichokes.htmor 30 minutes. Enjoy by peeling each leaf and extracting flesh using your teeth.

Beets

Farmers market beets are often sold with the top greens intact, a nutritionally-dense bonus for shopping local. Khoury recommends cutting the greens from the root as soon as possible to keep the roots moist.

“Beet greens, just like other greens, should be washed thoroughly in clean running water and rinsed in saline water for about 30 minutes in order to remove soil, sand, dirt, and any insecticide residues before use,” says Khoury. “Top beet greens should be used while they are fresh. Beetroot, however, can be kept in the refrigerator set at high relative humidity for few weeks.”

Health benefits
“The beet is a rich source of B-complex vitamins like as niacin (B-3), pantothenic acid (B-5), pyridoxine (B-6) and minerals such as iron, manganese, copper, and magnesium, which benefits anyone who wants to reduce inflammation in their bodies,” says Khoury. “Beet root is an excellent source of the phytochemical compound glycine betaine, which is also found in other vegetables and recommended to maintain strong cardiovascular health.”

Don’t forget the top greens, they are packed with benefits. Just 100 grams of chopped beet greens – that’s around a handful – offer 30 milligrams, or 50% of the recommended daily amount of vitamin C. It’s also an excellent source of vitamin A, which supports growth and repair of body tissues; immune function; eye health and night vision. Sautée beet greens and fill up half your plate for brain boosting, cancer preventing and immune strengthening.

How to prepare
Khoury likes to peel, shred or thinly slice fresh beets into salads; and sautée the greens with a bit of olive oil, chili flakes and garlic as a side. Other suggestions: Avocado, Beet and Chicken Tostadas; Roasted Beet, Walnut and Arugula Salad; or Beet, Orange and Jicama Salad.

Peaches

Juicy gems of the season

  • Peaches continue to ripen after they have been picked. If they were picked too early (still green), they will ripen at room temperature after a day or two

  • Smell them for a fragrant scent and squeeze gently to determine ripeness

  • Red indicates variety

  • Look for a golden yellow around the stem

Health benefits
Juicy and sweet, peaches are a Canadian favourite at this time of the year. They are low on the glycemic index and can be enjoyed by everyone including people with diabetes as part of the recommended 2 to 3 servings of fruit daily.

“A medium-sized peach is considered one serving is low in calories, carbohydrates and rich source of beta carotene,” says Vandana Gujadhur, a registered dietitian at Medcan. Gujadhur says other benefits include:

  • Low carbohydrate and low calorie choice

  • Rich in vitamin C

  • Beta carotene supports healthy skin

  • High in lutein, which may protect against age-related macular degeneration

  • Cardiovascular health: eating the skin and juicy parts of the peach can support heart health

How to prepare
Peaches are perfect with oatmeal for breakfast, or Gujadhur recommends adding chopped peaches to a fresh August salad of arugula, sliced almonds or walnuts, handful of chickpeas and a basil vinaigrette.

New prostate cancer research revisits early screening conversation

Men in their 40s and 50s encouraged to reevaluate their prevention strategy

By Tania Haas

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New research out of the U.S. adds additional support for early prostate cancer screening of men in their 40s and 50s, leading some advocates to hope that it may persuade reluctant physicians to reconsider their positions.

The Northwestern Medicine research showed that the number of new cases of metastatic prostate cancer climbed 72 percent in the past decade from 2004 to 2013. The report considers whether a recent trend of fewer men being screened may be contributing to the rise, or whether the disease has become more aggressive, or both.

Opposing positions about prostate cancer detection and prevention in Canada has led to inconsistent medical guidelines, which in turn has led to men getting different treatment recommendations across the country.

Cases rose 92% among men aged 55 to 69 in the last decade

As reported by Northwestern Medicine, the largest increase in new cases was among U.S. men 55 to 69 years old, which rose 92 percent in the past decade. This rise is particularly troubling, the authors said, because men in this age group are believed to benefit most from prostate cancer screening and early treatment.

Dr. Edward Schaeffer, the senior study author and chair of urology at Northwestern Medicine said that one hypothesis is the disease has become more aggressive, regardless of the change in screening. The other hypothesis is since screening guidelines have become more lax, when men do get diagnosed, it’s at a more advanced stage of disease.

Early screening is something Medcan Chief Medical Officer Dr. James Aw and Dr. Rajiv K Singal, Director, Medcan Urology and specialist in Urology at Toronto East General, have been promoting for years.

“The PSA test is by no means perfect. However, it does form an important component in an ongoing and developing series of algorithms designed to predict whether a given male will develop prostate cancer, and whether that cancer will be a dangerously aggressive form of the disease. Early detection of the aggressive forms of prostate cancer in younger males (aged 65 or less) saves lives”
— Dr. Aw.

Early detection saves lives

In his article on PSA tests in a National Post in 2011, Dr. Aw argued that early detection saves lives.

He encourages men in their 40s and 50s to speak with their physicians about the best screening options for them.

“We can’t simply abandon an entire generation of men waiting for something better to come along. Those men that are destined to be harmed by prostate cancer must be found and offered a chance at cure,” says Dr. Singal.

As Dr. Singal has written on his site and elsewhere, until there is a better tool that is widely available, he believes the PSA is the best thing that we have.

“While we have some knowledge about clear risk factors such as family history and ethnicity, in my experience the large majority of men that have presented with meaningful disease have had no clear or prior risk factor,” Dr. Singal wrote in a 2013 posting.

One of his most popular pieces “My GP Just Doesn’t Believe in PSA” helps male patients navigate the medical system when family physicians who are reluctant to recommend a screening.

The mind-enhancing impact of exercise

This specific mindful and aerobic practice reduced depressive symptoms by 40%

By Tania Haas

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Long-time runner and Medcan physician Dr. Steve Hirsch says he practises three types of meditations when he runs marathons. Hirsch, who is in his early sixties, completed his 28th marathon this year, laughs off friends’ pestering when they ask him how he doesn’t run off course.

Hirsch calls it meditation; others call it mindfulness. Now researchers say a similar mind/run routine can be used to reduce the ruminating and negative thought patterns associated with depression by as much as 40%.

Mental and performance training for depression and anxiety

Rutgers found that the mental and performance (MAP) training reduced depressive symptoms in a group of young people with major depressive disorder by an average 40%. This MAP training consisted of 20 minutes of silent sitting meditation, 10 minutes of silent walking meditation and 30 minutes of aerobic exercise at moderate intensity.

This study may also explain why runners often experience the ‘runner’s high’ when they find themselves in the ‘flow’ or ‘in the zone’. Here’s an excerpt from Medcan staffer and running blogger Amy Friel.

In the day-to-day, getting “in the zone” on a mileage run can be extraordinarily useful. In psychology, this is called a flow state. Flow is a completely focused, single-minded immersion in an intrinsically rewarding task. Our emotions and impulses become channeled and contained.

“While the experience of flow is overwhelmingly satisfying and positive,” adds Friel. “It involves the sort of deep focus on nothing but the task at hand, wherein our emotions and even ourselves slip quietly away.”

Meditations adapted for running

During his marathons, Hirsch starts with an awareness meditation (actively taking in the scene, the sounds, the people with an underlying attitude of gratitude), followed by an adapted walking meditation and then a body scan, which is a different type of meditation.

Skin care for every decade

Because 90% of visible aging is sun damage, sunscreen is your best defense.

by Dr. Julia Carroll, Dermatologist
As told to Tania Haas

Photo by Autumn Goodman on Unsplash

Photo by Autumn Goodman on Unsplash

Just as fashion and habits change as we age, so should our skin care regimen. Age-specific treatments and routines can airbrush evidence of poor practices, smooth your skin’s texture and reveal a reflection that’s the best and most refreshed version of you.

At any age

Because 90% of visible aging is sun damage, sunscreen is your best defense. As a bonus, it also helps prevent skin cancers. After sunscreen, I recommend adequate sleep and avoiding cigarettes. It’s amazing how eight hours of beauty rest and healthy living can give you a natural radiance.

Recommendations: My favourite sunscreens for the face are those created by the companies Elta MD, Skinceuticals and LaRoche Posay Anthelios. These are all high-quality products because they contain specific UV filters that give excellent protection from harmful rays.

In your 30s

This is your skin’s sweet spot. Everything is in balance. However, you may start to notice you can’t get away with late nights and poor eating habits as much as you did in your twenties. The skin can start to thin and lose collagen in this decade.

Recommendations: In terms of topical treatments, I recommend retinol, a chemical compound that’s produced naturally in the body, a form of vitamin A. Using it on your face boosts the health of the epidermal layer by increasing the levels of collagen and increasing cell turnover. This leaves your skin smoother, with less visible wrinkling and decreased pigmentation.

In-clinic treatments include options like salicylic acid peels, ideal for women who are suffering from acne but are starting to see the subtle signs of aging. Peels in general work by removing surface layers of the skin, encouraging more skin turnover and revealing more even-toned skin.

In your 40s

You might start to see fine lines become more entrenched and sun damage appear more obvious. There could also be hint of volume loss, which can make the mouth area appear sad. In some women, rosacea also may develop or become noticeable at this time.

To decrease the inflammation and breakouts associated with rosacea, consider topical treatment gels like brimonidine and metrogel, as well as the newest topical medication Ivermectin. You can also choose a once-a-month laser option (we call it the anti-rosacea boot camp at Medcan) to reduce redness.

Recommendations: Antioxidants work together with your sunscreen to reverse sun damage and help with collagen production. The most important antioxidant is topical vitamin C (or L-ascorbic acid). Your topical vitamin C product should ideally be pharmaceutical-grade (purchased through a dermatologist or a plastic surgeon) and should be in serum format.

In your 50s and beyond

The fifties and sixties can be challenging, especially for women going through menopause. Varying hormonal levels can have an impact on our skin including loss of elasticity, adult acne and dryness. The face and its underlying structures can lose volume; you start to get thinner in the middle of your face and wider along your jaw line.

Recommendations: Moisturization is key for keeping skin looking its best. Dry skin can accentuate fine lines. Try adding an oil or serum to your routine. One of my go-to’s is Skinceuticals B5 Hydrating gel. I use it before my daily moisturizer and never fly without it.

When in doubt, check it out

Beyond the cosmetic aspects of skin care, abnormal dark spots could indicate a health concern. If any spots appear suddenly, grow quickly, are asymmetrical or have different colours, book an appointment with a physician right away.

Dr. Julia Carroll a lecturer at the University of Toronto and the consulting dermatologist for L’Oreal Paris Canada.

Beverages with benefits

Drink your produce with purpose

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By Tania Haas

When you prepare your produce right – keeping the ingredients as whole as possible – blended juices and smoothies are an easy way to meet your daily goal of plant-based foods.

The nutrition team at Medcan cautions that while cold-pressed juices may be alluring, there is very little evidence to support the marketed benefits. For one, the vitamin- and mineral-rich edible skins, seeds and pulp are removed in the juicing process.

To ensure your beverages have the most benefits, follow this approach.

Stick with blended or “whole” options.
Drinks that include the fibrous skins, pulp and seeds (rather than just the juicy or soft parts known as ‘flesh’) have brain and body boosting benefits, including more antioxidant activity.

Choose blends with a higher ratio of vegetables to fruit.
Vegetables generally have lower sugar levels.

When indulging in pure juices, enjoy in small doses.
No more than ½ cup daily to keep your sugar levels in check and your kidneys in equilibrium.

“Even the purest versions have an excess of sugar that would be better consumed over the day rather in one serving,” says Stefania Palmeri, a registered dietitian at Medcan. “Excessive intake of juices can strain the kidneys and contribute to kidney stone formation, particularly when fruits and vegetables are high in oxalates.”

Avoid processed and packaged products.
The extra sugar, salt and preservatives offer no benefit to your brain or body.

Try three of our favorite beverages with benefits you can blend yourself.

Pink Powerhouse: a pre-workout energy boost

“This is perfect to charge you up before a big workout,” says Alexandra Friel, a registered dietitian and long-distance runner. “The sugars from the fruit provide quick energy for working muscles.  Beets are a natural source of inorganic nitrate, which our body converts into nitric oxide.  Nitric oxide is known to improve muscle contraction, blood flow, and neurotransmission –  all of which improve exercise performance.”

  • 1/2 English cucumber, peeled and roughly chopped

  • 1/2 small raw beet, peeled and roughly chopped

  • 1 apple, cored & roughly chopped

  • 1 fresh grapefruit juice, to taste (suggested: 6 tbsp fresh grapefruit juice) or other citrus to taste

In a high-speed blender, add the cucumber and blend on low speed to break it up. Now add the beet and apple. Blend, starting on a lower speed, and gradually increase the speed. If needed, add a bit of water. Blend on highest speed for 1 to 2 minutes. Add in citrus juice to taste and about 4 ice cubes. Blend again until smooth. Serve immediately. (Adapted from OhSheGlows.com)

Tart Tropical Spin: support your gut health

“This beverage includes kefir, a cultured dairy product packed with probiotic bacteria that keeps our digestive tract happy and healthy,” says Palmeri. “Research from the American Psychological Association reports that 95% of the body’s serotonin levels are produced by gut bacteria, which can influence mood, cognition.  Feeding the microbiome with kefir’s magnesium and calcium supports the nervous system, while its rich B vitamin content is linked to brain function.  Preliminary studies in animal models are also quite promising, as kefir may play a role in cholesterol metabolism, tumor suppression, increased speed of wound healing, and immunity.”

  • 1 cup frozen chopped mango

  • 1/2 cup frozen sliced strawberries

  • 2 tbsp chia seeds, hemp seeds or ground flax seeds

  • 1 to 2 cups kefir (fermented milk drink)

  • 1 1/2 tsp liquid honey or 2 tsp of maple syrup

  • 1 tsp vanilla extract

Using frozen mango and strawberries creates a thick smoothie. For a thinner smoothie, use fresh mango and frozen strawberries. In a blender, combine mango, strawberries, chia, hemp or flax seeds, kefir, honey and vanilla. Purée until smooth. Pour into chilled glasses and serve immediately. (Adapted from Cookspiration.com)

Green Goodness: boost and protect brain function

“Leafy green vegetables are nutrient dense and lead the charge in the foods supporting the treatment and prevention of depression and mood disorders,” says Vandana Gujadhur, a registered dietitian at Medcan. “This recipe includes both kale and lentils and optional dried fruit for sweetness. Feeding the microbiome with plants has also been linked to improved brain function.”

  • 1 cup chopped kale, spines removed

  • 2-4 pitted dates (as per sweetness preference)

  • 1 medium banana, peeled

  • 1 apple, cored and chopped

  • 1/2 cup crushed ice

  • 1 cup fortified milk substitute such as soy beverage

  • 1/2 cup cooked split red lentils

  • 2 tbsp lemon juice

Blend all ingredients until smooth. Refrigerate or enjoy immediately. (Adapted from the Dietitians of Canada.)